OBJECTIVE: To investigate the factors related to the "egg-like vertebral body" phenomenon after the reduction of thoracolumbar fractures with whiltse approach. METHODS: Retrospective analysis of 119 cases of thoracolumbar single-segment fractures treated with vertebral approach and pedicle screw system reduction and internal fixation in our hospital from January 2016 to March 2019. Postoperative follow-up 12-19 months, and the CT examination was completed 1 year after surgery. A total of 74 patients with complete preoperative and postoperative follow-up imaging data were included in the sample size. The incidence of "shell-like vertebral body" was observed by CT image of the injured vertebra at 1 year postoperatively, and the age, sex, BMI index, preoperative vertebral compression degree, preoperative sagittal Cobb angle, preoperative intervertebral disc integrity, vertebral nail placement, postoperative fracture open reduction and other related factors, through single factor analysis and multivariate logistic regression analysis of various factors and "egg-like vertebral body" occurred The relationship between the factors and the correlation between the factors and the "shell-like vertebral body" was verified by the ROC curve. RESULTS: 40 of the 74 patients were found to have an "shell-like vertebral body" after surgery, with an incidence of 54.05%; 35 patients had no clinical symptoms. Univariate analysis showed that the patient's preoperative vertebral compression, fracture open reduction, vertebral nail placement and preoperative disc integrity were significantly correlated with the occurrence of postoperative "shell-like vertebral body" phenomenon ( P<0.05), and the age, sex, BMI index, preoperative sagittal Cobb angle were not correlated analysis showed that the patient's fracture open reduction, preoperative vertebral compression and preoperative intervertebral disc integrity were independent risk factors affecting the postoperative "shell-like vertebral body" phenomenon. The area under the ROC curve was : 0.660, 0.706, 0.646 (P < 0.05). Conclusion: Patient's intervertebral disc integrity, degree of vertebral compression, fracture open reductionare are the independent risk factors for the appearance of “shell-like vertebral body” after trovelse approach for thoracolumbar fractures.